The progress of efforts to repeal and replace the Affordable Care Act (ACA) remain unclear.Proposals to repeal the ACA Medicaid expansion and to convert Medicaid to a block grant or per-capita capped financing model have created controversy within the Republican Party and beyond. The Congressional Budget Office estimates that changing Medicaid to a per-capita capped program could eliminate $370 billion from the program over the next 10 years. Such a reduction would force many states to change eligibility standards and to make deep cuts to benefits and reimbursements. Repeal of ACA taxes on wealthier Americans and an extension of tax credits to the same population would also mean that 50% of tax benefits from ACA repeal would accrue to those with incomes above $1 million, according to the Tax Policy Center.
For housing advocates, a rollback of the ACA Medicaid expansion or a transition to a block grant or per-capita funding mechanism would result in a dramatic reduction in resources to supportive housing services, which have been essential to reducing homelessness. According to the Center on Budget and Policy Priorities supportive housing services reduce health care spending by $6,000 annually per individual served and allow individuals to spend 115 fewer days in homeless shelters. Earlier this year, Washington State was granted a waiver to provide Medicaid supportive housing benefits for such activities as helping individuals with the housing application process and developing a housing crisis plan. Medicaid expansion under ACA has provided states more funding to create these types of programs for the people who need them most. While coverage is not always comprehensive and can vary between states, repeal of the ACA Medicaid expansion or converting Medicaid to block grants or a capped per-capita system would threaten the progress many states like Washington have achieved.
Many groups are working to mobilize opposition to the repeal or inadequate replacement of the ACA, including the National Alliance to End Homelessness and Protect Our Care, a coalition that includes Families USA, the Center for American Progress, and NAACP, among others. The campaign’s webpage lists ways for advocates to get involved and provides resources and tools for contacting Members of Congress, submitting letters to editors, and communicating on social media.
For CBO estimates of the impact of per-capita capped financing of Medicaid, visit: http://bit.ly/2lOwpML
To learn more about block granting and per-capita capped financing of Medicaid, visit: http://kaiserf.am/2kR9gGO
For more on the tax impacts of ACA repeal, visit: http://tpc.io/2ipiqaz
For more on CBPP’s research on supportive housing, visit: http://bit.ly/2lDxd6x
To learn more about how the Centers for Medicare and Medicaid Services encourage coverage of supportive housing services, visit: http://bit.ly/2mglqg3
To read more about Washington State’s Medicaid supportive housing program, visit: http://bit.ly/2lEEC3Y
For the Health and Human Services report on Medicaid and Permanent Supportive Housing for Chronically Homeless Individuals, visit: http://bit.ly/2lExbcO
To learn more about the Protect Our Care campaign and get involved, visit: http://bit.ly/2kRC93O